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Writer's pictureAbderrahim Benmoussa, phD

Clinical course and risk factors, a retrospective study

Updated: Apr 6, 2020

Quality of evidence: B-

 

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

 

Authors: Zhou F et al

Journal: The Lancet

Objectives: Identify the characteristics of patients with COVID-19 and the risk factors for death

Strength of evidence: Moderate (well-designed cohort study, however retrospective, a limited number of deceased patients, heterogeneous population)

Methods/publication type: Retrospective multicenter cohort study on patients affected by COVID-19 in Wuhan

Highlights :

  • Out of 191 hospitalized patients, 137 (72%) were cured and 54 (28%) died

  • 91 (48%) had comorbidities, mainly hypertension (30%), diabetes (19%) and coronary artery disease (8%)

  • Risk factors for mortality: age over 70, comorbidities (hypertension, diabetes, coronary artery disease) and if resuscitation was performed

  • The Sequential Organ Failure Assessment (SOFA) score was useful to predict the risk of death

  • Increased signs of severity: FR> 24, SOFA score> 6, GB> 10G, lymphocytes <0.02G, creat> 133

  • Lactate> 245, tropo> 28, D-Dimer> 1 and they increase with time in non-survivors

  • The median duration of infection is 20 days (IQR 17 · 0–24 · 0)

  • Chronology of appearance of symptoms is not different between the level of prognosis: the first day = cough + fever, day 6 = dyspnea, then disappearance of cough + fever but need intensive care between D12 and D18

 

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